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Nighttime Sleepiness Evaluation
SCREENING FOR SLEEP APNEA
Developed by David White, Boston, Massachusetts, 1998
1. Snoring:
a) Do you snore on most nights (more than 3 nights/week)?
Yes (2) No (0)
b) Is your snoring loud (can it be heard through a door or
wall)?
Yes (2) No (0)
2. Has it ever been reported to you that you stop breathing or gasp during sleep?
Never (0) Occasionally (3) Frequently (5)
3. What is your collar size?
Male: less than 17 inches (0) 17 inches or greater (5)
Female: less than 16 inches (0) 16 inches or greater (5)
4. Have you had, or are you currently being treated for, high blood pressure?
Yes (2) No (0)
5. Do you occasionally doze, or fall asleep during the day when:
a) You are not busy or active?
Yes (2) No (0)
b) You are driving or stopped at a light?
Yes (2) No (0)
TOTAL SCORE: _______
9 points or more: You LIKELY have Sleep Apnea and
should be evaluated Immediately.
6-8 points: You MAY have Sleep Apnea and should have an
evaluation.
5 points or less: It is Unlikely that you have Sleep Apnea,
but should you experience changes in your
sleep or sleepiness, call us for a FREE
evaluation.
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